you guys have room for some more you go to default pressure first now let's go a little bit more tell me where you fall asleep um when we look at Bloods the blood itself we need to look at the component look the function let me go through right red blood cells white blood cells have you ever played this before yeah the coagulation oh look Claudine that's what we're gonna talk about that we talked briefly about plasma and an auction that carbon dioxide transport and then we do block moves to finish that one off and then we do the lab of water so blood is a fluid transportation tissue it's a connective tissue it has connective tissue parts it has cells connective tissue in it cells and connective tissue as an extracellular matrix and an extracellular matrix always has fiber in what is not fiber that you see it's called soluble fibers you could dissolve it in liquid so we call that five of their five greater gender that's a little side note we talked I think we talked briefly about that when you see the Virgie DN usually it's in an enzyme Deborah comes from Genesis as in creation and so that means usually that is in the process of being made so if I brain a gen T soluble and once we make it into fibrin right here fibrin then it's insoluble and it participates out in liquid it makes the board clumpy all right I know it's almost kind of productive little bit soluble means it's like sugar ins in water it's dissolved insoluble means it's not dissolved it sticks out from the water so it blocked that because we're so we'll talk a lot about that because that's a very well not a lot but more that's a very delicate situation in the world but the blog has all those connective tissue components it's got its got the cells it's got the extracellular matrix and that's the liquid that's the plasma is liquid and that fibers we look in our body we ever buy eight percent of our weight is blood a person of seventy kilograms about five point six liter that's five point six million a gallon cord find something else that way since leaders are not that easy the cellular component of blood all cellular components of blood are made in the red bone marrow that's important so that includes red blood cells white blood cells and then these platelets they're all made in red bone marrow so that's inside the bone remember the bone was made on the outside it's mostly this compact bone that's a long time ago in Chapter four well the answer is like the bone that looks smooth this compact and then you see a bone if your phone breaks it's got spicules coming out like it's not really smooth you can see that plastic but in real bone and on the inside these big holes are like scaffolding bone and there's a lot of room on a space in between and inside that space we got the red bone marrow not in our bones very many bones like in a hip bone for example so somebody has leukemia we have a problem with the bone cell I mean the blood cell formation of white parts are free and they take the biopsy out of here to see what's going on they take the biopsy there's a red bone marrow to see what's going on blood cells are expressed as a percentage of total volume and we call that the hematocrit so you see your Humana freight you know that's the cellular components the higher demand great the last liquid it has a percentage rights the more stinky the block gets the more dense the Balkans so average is about 45% so 45% of blog it sells 55% of what is the rest we look at functions the RBC's the red blood cells oh look there's a spelling thing that is no T did you really throw point the erythrocyte all right whoa what full of red blood cells and they transport oxygen from the lungs to the tissues and carbon dioxide back to the lungs good that's a function we like that function white blood cells defend against pathogens and foreign bodies that's an immune function we'll talk about the white blood cells we'll pick up the new system abundant and then we have a whole bunch of other stuff dissolved the plasma and as an auto function is transported so the blood can transport nutrients waste or hormones through it and deliver it to the body so it's like a freeway system of bringing things around the country law of coagulation happens but eventual is broken and needs repair so in the cotta vessel you know you bleed you come to self you bleed me that there's a vessel in saqqaq somehow I'm going to patch that vessel up so what happens is that insoluble fiber in here that fibrinogen somehow magically becomes strands that that precipitate out that they can make a patch and they called in that fibrin and that's an insult fire because it does not in soluble means not dissolve in water and then together with the platelets they can patch up that break and repair the vessel so that's cool that's the short of that coagulation thing then also what can carry heat that is produced by two orleans to the body surface so the blood on the inside can pick up heat when it's warm and you bring it to the outside or we can add and through that process because of course blush and they feel warm but we cool the inside of the body download also in its BD we called what will go away from the outside and preserve it on the inside that's when you know your finger falls often it's like Oh too bad you still have a heart that's pumping but thank God we don't have it here we have to deal with order stop this latitude so the cells of blood are the main ones we have here are the red blood cells to a ruthless I gotta spell right here we have per microliter about four and a half to five and a half million Oh a microliter that's like a millimeter time you know what a millimeter is and millimeter is like this and decimeter is 1/10 the saint is a hundred seventy means a hundred centimeters 100 of that and it mainly means a thousand that's like a thousands of this so that's this little thing so a cube of that has four and a half to five and a half million RBC's to me it's just I don't understand it that's it one of those numbers it's just a lot and so this is around the cells of them are round so they're circular but the disk shape which both sides go on inside so they're both sides of the dish or concave like oil into a cave and that gives us optimal surface to volume ratio what the heck is and that means everywhere on this cell the distance that the oxygen has to travel to the every point is the same distance pretty much or it's optimal so that the amount of surface it has to the amount of inside volume it has is optimum for the gas to exchange if it were just round it would be way too much volume for its surface to figure that out so it's disk plus it's convenient when you go through blood vessels they can stack up and they go through all the smaller capillaries that way like in single file the red iron containing protein hemoglobin we talked about hemoglobin a little bit and talk to a protein probably one of those important ones burrows for us they bind reversibly to oxygen so that hemoglobin actually the iron in it the heme in it can attract an oxygen and let it go oxygen-rich blood is a little bit brighter red and option to pause a little bit darker red that's why they have the veins or the deoxygenated blood I should say look in the bluish on the models versus red for for the oxygen containing vessels and then I'll be a just talked about the diffusion distance which I mentioned that that's optimal with this configuration here so that's that dishes need optional adsorption Pratap that enormously production the RPC production is regulated by a Ruth reported and that's a hormone down by the kidneys renal is kidney the kidneys what makes the P the filtering of the block so dialysis patient the ones are going to go with the kidney thing helping the kidney they are often deficient in this hormone creating this resource with RBC count keep it in anemia anemia is when we don't have too much of them we have two little offices that means you have too little oxygen carrying capacity that means we have weakness we're fatigue that's a function of Anita if you don't have any energy I always totally sluggish anemia could be one reason for that an increased number of red blood cells is not anemia that's called poly SCI tinium poly means many polycythemia and and they do that sometimes athletes they go they do blood doping they go up to two high out to like Colorado City or Coral Springs and and where they train and then the blood there has led that the air has less oxygen so the block needs to be thicker we need more or B C's made to carry the same amount around because it's not as easy accessible from the air and then what they do is they come down to sea level to compete and so at that point they have more RBC's in the block and so they have more options or do the dishes that means the more energy they do that artificially by taking blood out and then putting it into the body right before competition but that can be dangerous I mean all this can be dangerous but definitely when you do it on officially I did but you know you can win that way so that's our pcs only lived 120 days three months they're developed from stem cells in the bone marrow at a rate of about a hundred and listen there's a hundred and sixty million every minute well if you've got four million or five million in that little screening time you think you're gonna make water they're broken down by the liver and the spleen the iron is reused for recycling but other portions are used are extremely thin it's almost more used in bile salts have you ever gone black gallbladder stones so the bile is is made by the liver and it's dumped into the stomach into the God to emulsify fat and emulsify fat means you know fat in water is like salad dressing the oil in the vinegar the fat comes together it always wants to stay together you have to shake it before you to wear it otherwise it's together and and it's the same in a liquid environment in the stomach because it's mostly a watery environment so the fat will come together so we have this molecule the bile that has on one side it has a it's polar on the other sides it's nonpolar and that's back to the hydrophobic hydrophilic so now you can have two if this is the if this is the nonpolar if this is the polar you can have the fat be attached on the inside and make these little things these little globs which the polar going to the water that nicely swings around in the water and the fat does no accumulate because it gets interspersed by these little things by the by us all that then emulsified that's the same the soap in the water when you do dishes this is the same concept of the soul it takes the oiler it emulsifies the water so we can use this is the byproduct of the red water I'll break down for that so that's pretty cool that will be killing digest fat better good so that brings me then to the white blood cells will have per microliter we don't have five million now we go somewhere between four and eight thousand that's much much less still but maybe look at that white blood cells the technical term is leukocytosis leuco means white leukocytes so we have two main two main groups that are differentiated by how they stain under the microscope what are the granulocytes when you take stain in the microscope they create little granules that we can see and the other ones are a granulocytes that means they do not a means they do not have a breath random asides or three of neutrophils eosinophils basophils more turn and then a grande other sides we got lymphocytes and monocyte lifespan of these suckers is from a few hours to a life spent a lifetime sorry and the white blood cells you probably know that they make off the structure of the immune system and then together with lymphoid organs from the lot of the lymphatic system they help us implement immune system this is how they look and we have these plaques and for us this is how they look and so that's what we're gonna do in laughs a little bit too because over time for the final we're gonna for the last test we're gonna identify what's this what's this what's this so that's good ass but it's not that big of a deal she was gonna quite a simple one but I like this you know if you have to go further in the anatomy stuff there is little smaller descriptions here that kind of uh or nice I don't want to go too heavy into them I want more go with the function then um but before we do with the different ones we also have these terms Mukul the term leukocytosis is an inquiry leukopenia wherever that way okay the leukocytosis in the increase of ipod cells over 10,000 per microliter which usually is an infection swollen lymph nodes is what that is well that's small and lintels if we go below mm we got a little bit of a problem with I mean enough white blood cells they call it leukopenia the word Pina means diminished osteoporosis is brittle bone before we have that if osteo pineal they call that because with diminished bone density so that when peanut comes back overall that usually means the damage to the side of the formation and can be corticosteroids huh don't do too many corticosteroids don't think too much practice um do you step forward you reading I freaked out when I have people that are like it there's 30s or even twenties they're on steroids unless they really need it look like what you gonna do when you're 60 and I have stories for people they caught they all freaked out because they're paranoid so I had prednisone forever and they didn't realize that it damages the immune system and now they're always sick because one of the problems with I will meet was it said to remember to turn retail medicine our medical systems retail medicine it's like high-volume retail medicine and in this high-volume retail medicine environment we miss all want to stop so one of the reasons why I take this class I think is to understand more of the stop so we can ask critical questions and say what was law I would think about this because very often when I have some patient I come in and they're like I mean sometimes it's just a lot of times I guess it's the way the patient presents but you also you know sometimes you like who thought about this case before you know for me it's especially when it's with musculoskeletal stuff that doesn't clear up and anyway but but just you know we need to know about this a little bit of course we can have to cancer leukopenia can also be luke leukemia can cause that to cancer except for some white blood cells and red and the white blood cells most of them and the red blood cells mature and proliferate both in the bone marrow the red bone marrow so they're all made there some of the white blood cells namely the lymphocytes we'll talk about those other those are the B and T cells have you heard T cells hate the other mates right that's where the T cells go work they're not enough T cells around the HIV calls it to the T cells to go down and then AIDS is when we get the disease expression and so they are made in the thymus which is right here behind the sternum everybody else know they're made they're made sorry they're made in the red bone marrow but they mature they learn how to be in this world in the thymus everybody else has a maturity and I guess we can call that differentiation in the red bone marrow so that's the only difference we'll get to that in a little bit when we talk about the fineness of the B of T cells boring depth for right now just think most of the rap most of the bone cell most of the blood cells are made in the red bone marrow so now let's think about this white blood cells are here to defend us against infections they are here to help us get rid of the bad invaders or the bad stuff get rid of some of the cancer stuff too a lot of the cancer stuff actually so but then we have let's say Mia never copped out in here and the needs of you bleeding and a lot of bad thumb comes in and gets infected and all that stuff what are we gonna do about that what's the body gonna do about that the body's going to send a lot a lot of white blood cells to that area there we go calm and the question then comes on how the hell does the body know what to do how to develop lots of snow to go there and into a few things they have chemokines whatever the chemicals like perfume chemicals or something they are recei created from the area where the injury is happening and they send out a signal that attracts white blood cells and so they call that process chemotaxis so the chemical is like the taxi sends it right to the place where it needs to go so that's kind of cool I think of it like it's a perfume that is like oh it smells so good I gotta go there it's like they do that and they do that via motion amoebic motion so they can move like an amoeba they can grow they can move through space that way so they're they're mobile and they also if they are regret what's up and if they're in blood vessels they also have to escape the blood vessel in order to go talk to the tissue and help in the area where the problem is and that process have walked you through or passing through the vessel wall is known as die of PVCs dinah means through PDC's means full-on pigment form so those are three terms that are sort of helpful as distant chemotaxis the Amigo in motion and adaiah thesis so that gives us a way to bring white blood cells to the area birdie or needed and so most of the Bob cells and most of the white blood cells that are actually going to that area first in an infection or the neutrophils and the neutrophils they phagocytosed or phagocytosis Farge means eating so they ingests for material which is a pathogen and destroy it by releasing lysosomal and remember we talked about that lysosomal chance that enzymes in it is one of the organelles when you go back to the cells and so the lysosomal enzymes have a lot of hydrogen peroxide in it they can destroy stuff they break it down and then often what happens is when they break things down and eat up the bad gun that can take on into the system they often then perish themselves and then we have pause and most of us go like oh that's so gross you don't know like have a good T cells they died for me when you feel the price find some pause and go be grateful by oh so they reach the side of inflammation first and our main part of the what we call a nonspecific immunity when we talk about the immune system you have some immunity that's nonspecific that's like you get caught you need to fix it but then we have some immunity that's very specific like you gotta get chickenpox and once you have the chickenpox the system knows what chickenpox looks like so you don't get it anymore that's called the specific immunity the bird specific refers to what makes you sick that specific thing you know you're going to be attacking real fast again that's the whole idea of immunizations uh vaccinations and so alright so that's that one very important so I mean I looked at my track and I look at my plaque and I only have four plaques for some reason they didn't know in the cabinet so you just had but we'll have it open next time I will look it over the world but you see there is these things they have like these dots these bread dots there's one it has blue dots and the song it had no no dogs with their stalks so they're neutral happen where the dots look neutral they look like the background those are neutrophils so the granules are neutral that's why I came over their name at least I'm bored with that story and then when we do it in level just go around to show you so it's not going to it but then we have the ones with the red dots are known as the eosinophils and they phagocytize antibody and two complexes in bomb to excess histamine limiting allergic reaction they also here to attack parasitic worms we have parasitic worms in our system yeah you would if you don't have those well get rid of them mm-hmm and so when we study those those are ones who have the red dots or the more orange looking with the reddish and the monomyth memorize sort of the limit allergic reactions and they attack parasitic worms that's what they do for standing up the basil fills in the basil fills on the blueish ones and David Lee's histamine and heparin histamine is the hypersensitivity reaction that's all the sneezing that's the allergies they spin histamine and heparin increasing what they do is to increase vascular permeability and contract smooth muscle and then it's also an anticoagulant and terms of the heparin and so that can give you a lot of season going on so then you have those who kind of help with binding to the histamine and reduce in yellow to react so we got to play little teeter-totter with that yeah that's your yeah they're saying this year is allergy season already soon we can't go outside so those are the three granulocytes then we go up to a granulocytes and we have two times we have lymphocytes so this is where you have to be careful we have all of the white blood cells are known as leukocytes the specific group that I'm talking internal is lymphocytes so they're mortal in the lymphatic versus Luka not white but it's a very close name so those are the B and T cells they usually have the small a large nucleus and our small file on the blood stream but they get large once they reside in lymphoid organs which means your lymph nodes or the spleen is also look for the word but that's the lymph node for example they are in doubt the organs that they're sitting there they're living there it's like their home so once during those situated places then they become nice and large and those are the cells of the specific immunity they remember the chickenpox or the flu vaccine the flu that they gave you and I want to start taking the flu EXCI I know I listen to us have you ever listened to Joe Rogan yes he doesn't that it his stuff at all it just puts it straight up but he's got like the biggest so yeah he's got some very interesting people that he talks to he's a little goofy but you know we straight forward and he talked to this guy who was on they had a thing about AIDS know about vaccines and autism and he's called an autistic child himself and he's a neurologist guides mister specialist and all that it was very very interesting I should figure out that episode we should be as you want because it talked he talked a lot about like autism and vaccines can't go together because the autistic genies get created in the second trimester and stuff like that and they really down the time to firmly down to earth from whatever how much you can put that down works but he also talked about the flu and how its system is one of the big to be killers in the Western world and so he was very Pro flu vaccine so I was starting to think maybe I should do that anyway the B cells of the T cells are part of the specific immunity so they get your chickenpox your measles all that that you get vaccinated from they learn that from your vaccination or for being exposed and learn what the pathology looks like the pathogen the t-cells are themselves involve any new response so they go attack the bad stuff themselves they're like shoot the time if you go they have my thank you for reset so they call it cell mediated the B cells make fragments of cells small little fragments that they release into the bloodstream and then they bind to the pathogens clumping the pathogens together or or tagging and saying like hey you gotta come kill this because it's a wrong thing we don't want it so the B cells are the taggers are called the taggers and the tags or antibodies they call the tax they call antibodies so antibodies are made by our body to protect against stuff of course if it goes out of hand the antibodies protect the wrong stuff that's our stuff and then we have a problem because then we have a wrong attack autoimmune disease is something like that and then the term antigen is on the pathogen so the tags are ours our tags for bad stuff our attacks for antigens which are a pathogen so the pathogen is what makes you sick makes it right that's the pathogen makes you fat gives you pathology the antigen is on the pathogen so technically speaking the antigen is the part of the pathogen that the antibody recognizes so it's almost thing you can almost say like it's the tag of the pathogen but for our purposes we want to associate antigen with the bad stuff with the passenger that way and the antibodies with our own stuff and so when we get to the next chapter we sort of have that language down already yeah that's basically that let's see what's next because now it's probably gonna get into wall typing soon cuz that's where that comes up big-time oh look at that we forgot one we forgot the last one is Apollo site and the monocyte are large contain a big knee shaped nucleus and had many lysosomes in it and they most of them live outside of the wall street as macrophages huh so you know so you associate monocytes with macro forces for example monocytes that in the bone we call osteoclasts we talked about the osteoblasts make bone they built them the osteocytes maintain bow and the osteoclasts break down bolded like pool counselor in the bloodstream so we have enough counselor in the bloodstream stuff like that they are actually monocytes they just went to the to the bow lunches or living in a bone for their lifespan we got some they call if in the liver they called Cupra cells we got something put in their lungs to come along John popper on cells no dose cells but the longer on cells are in the skin we'll talk about those we get to those organs but those are all monocytes that live in the tissues as macro fighters and what are macro forces to macro means big fuzzy teeny baby big stuff they do passages what they do is they phagocytose to destroy bacteria fungi parasites as well as worn out damaged cells whoo that's a lot of stuff so they helped us that's part of the dog specific immunity but then they do something else that's really cool they take and eat at pathogens the antigen part or they eat the pathogen and actually they present then the antigens on their surface and say I got infected I got attacked and I need to be destroyed and by the way you can learn about this pathology while you're here because I just picked it up and I recognized it and so they count that now specifically antigen presenting cells or dendritic cells because they look like they have all these spicules coming out like dendrites and they are sort of the link between the nonspecific immunity and this receiving humility because once once this Celsus eats the stuff and it recognizes some antigen and he presents it's like attending the BMT cells can come in and do the job and recognize boredom to do the antibodies and all that kind of stuff so that's cool ap see we're gonna talk more about those when we gonna talk about the uses here we go they're all there on here we did the ones with the granules the red does neutral the blue and then we got these two because the big ones and this models is immortal background to Marvel background or the B cells T cells to live full size the one with the big thing in the middle and pink background or the monocytes that makes them fine they'll ask what we have it's going to be the blue dots and the blue dots are going to be platelets let's see I think we're going to get to the plate that's pretty soon I hope so yeah look at that throne besides this there are four middle red bone marrow by what's called mega burial sites and again you have to test preview if these words freak you out just go with the flow and listen to the story and the names like I don't remember names in the story I was going to read open it again it's like that and you remember the names you need to know for the test okay for a lot of the functional stuff and if you haven't gone to test removal just do it after class for the functional stuff it's all written out there and for the terms I'll be clear about what we need to know for the test amount so they're made by megakaryocytes and then they're released in the bloodstream and small irregular shaped cell fragments those are the blue things the platelets they are destroyed within five to ten days by the please spleen room and they play a major role in blood clotting and we call that coagulation more plausible activation there's a you know and make a stem cell and mana parasite makes these fragments and then it sends me to the wall street with platelets that's pretty much it Batman so when we have an injury to a bed so we could be life-threatening obviously because we lose a lot of water organ canyons about a block and we need to patch that block that slope we need to make sure we don't lose that one so first we do if we slow down the bleeding by calling by a constricting they involve metals and we call that hemostasis the bleeding is slowed down so we don't just squirt whatever every cut out so this is followed that by thrombocytes which are the platelets that being deposited along the injured vessel wall as they stick to one another they call that aggregation the stinking part and they form a platelet plug when they do that and then what coagulation comes next and this is very delicate process because now we have the platelets that make this plot we have to the blood that doesn't flow as heavy but now we've got a coagulate Nami Nami God made fibrin and fibrinogen so we have to make this this the soluble fiber into an insoluble fiber that then can be like threads you know like gluey threads patching off those platelets even more [Music] this is a very very delicate process because if we have fibrin when we don't need fibrin we can create floating fragments in the body and giving us strokes we can we can chop those fragments and fall off or you know they can just precipitate in solution which is going to be a problem so when we look at making fibrin from fibrinogen we have a long process this is only like two steps out of like a 1213 step process that I didn't put up because you can only see there's so many little names and numbers it doesn't but they're called clotting factors that is the Cascade and they make from prothrombin to thrombin and then that is to the thrombin is what transforms the fibrinogen into an insoluble fiber called fibrin so you don't need to name very about all these names it's just I needed to understand the concept and I need you to know that it's very very delicate because you do not want to have strokes all over the place we do not want to have fragments floating around and if you go to behind an anatomy class then you can learn that right there yeah go straight sometimes but it's still too complicated for me but that's basically what we have we have to walk slowing down we have the platelets clean coming together aggregating and then we're gonna have fiber made out of fibrinogen and that patches to open up after the vessel is healed the enzyme plasmid dissolves the thrombus which is the patch and we call that fibrinolysis so the dissolving process is also very important because we don't just want to have these fragments floating around in the body well I did watch stream I guess and that brings me to plasma the blob plasma so when you take blood you put it in a vial you put it in a spinner called the st. review safety future spin it around with the you know pointing outward so everything pushes to the outside that's heavier so all that stuff goes down that that's heavier that's basically the red blood cells are the heaviest because of the island then divided port cells come on top of that and then everything else is plasma so we got look at that white blood cells and platelets they call that the Buffy coat because it's not red book and it's like not for me but it's a little wider and then above that is the it's the more yellowy plasma you see that's about normal that's anemia that's polycythemia just against us an idea a little bit and then we look at plasma we have serum and that's the plasma without the clotting factor the fibrinogen and that's also that's very very important because if you have plasma you let it sit around it's going to coagulate so you're going to have to take the fibrin part the fibrinogen out of it so it doesn't turn into fibrin it doesn't solve you know it stays in solute so that's then the serum that began most of the plasma is water about ninety percent is water ten percent is dissolved substances about 70 percent of that 10 percent is proteins and that we have nutrients vitamins hormones all in our stuff and some electrolytes plasma proteins the function of those are transportation of lipids blood clotting stuff and then antibodies for the immune system those are plasma proteins and then the ones that do this morning pressure let me talk about those are also proteases albumin is the most numerous proteins there they established just morning pressure for walk beside sleeping I haven't gotten also the albumin is the one that is a big player in what I talked landed waffles from the arterial into the cap erosion has to be picked up by the main you side so that still the albumin that does all of that see how much movie god I think we get there yeah lipoproteins other once the proteins that transport fat through the system because fat is insoluble in water and broader environment since water blood is hydrophilic water lobby in fat is hydrophobic border theory we have several classes of these lipoproteins and that's where we get into this cholesterol stuff for us we have a VLDL in an allele and they carry lipids from the liver to body tissues labor to body tissues and be considered at the good I mean I'm sitting at the bad cholesterol because they dispersed we dispersed the lipids in the body they take it from the liver and get it into the body now the lipids are very important cholesterol for example helps heal tissue it's very important to but it depends on how much at the quantity and so then the other one is the HDL and if you remember when you have a blood panel the total cholesterol is counted then the LDL and the eggshells come the LDL is the bad one the HDL is too good one so the ratio becomes a poor and so the HDL is a good one because it brings lipids back to deliver and that's why it still is too good cholesterol because it removes the lipids from the body and brings it to the liver for processing the ratio is important and it's the ratio as well as Tolkien so has predictive valuable individuals risk for vascular occlusion localized blood clots now having said that the reading Dean Ornish's book hint saying we have to be careful because value is like cholesterol before pressure or easily to imagine give us an objective value and then we can take medication to change the objective value that does not tell us the total picture of the health of a person in that respect in the cardiovascular respect there's many other factors so we always have to be very careful when you get blood values that's certainly an a marker an indicator of something but when we just take a medication to reduce that what value we've reduced the blood value what effect that does on health it's not always the same for example they have apparently diabetes medications that bring their the measurement in the blood off they're able to see or whatever it's called bring that down then it's not meaning that you don't have diabetes this means that level is better there's many other things that contribute to all that so we always want to be quantifying you know what's going on and you know it was medicine I like to be critical in the thinking because we tend to just sort of throw it at awesome and take it because it takes a problem puts it out of the way most we're good with that so but we do want to of course take it and be clear value and understand what we got and then critically think about what I'm gonna do about it for example you can do you know high intensity exercises and you're gonna get that HDL moved up a little and the LDL of Donavan so that's the lipoproteins the HDL LDL then we have disordered proteins that are the antibodies the immunoglobulins those are glycoproteins that give us the specific immunity by they're made by the B cells and then they bind to the antigens tagging them we just talked about that before and we call that opsonization actually as a term the tagging process then the white blood cells could go destroy it we have five groups or flavors of those if I G is the immunoglobulin they spelled IG and 1g they have a different end they have an E and they have D I'm not going to go through all of those but I really like this list when we go to an order school or pathology or so we have to learn them if we do that and then you have to learn the different groups one is founded lymph a still live stuff one is you know see see the pictures here also so it's good to have it's good to have these sort of hints a scanner well I like these burners pictures a little bit of text it helps us digest material pretty well it slows everything down I'm not that good with just words and antibodies activate for examples of the attack they oxidize the antigen but they also can actually activate a membrane attack complex and that can perforate a hole in the pathogen cells wall rendering them harmless if you take a beings boundary away it's it's one of the lines necessary things remember we have these it's not a survival it's a necessary function the boundaries a necessary function for us if we don't have a battery Brutus almost the rest of of nature and that's the end of us if a bacteria has no boundary a cell membrane it's going to be read enormous it's God on the inside is going to move out and these outside comes in and destroys so that's also good that's kind of like the MACC kind of like a big a big gun that makes a hole in itself that brings it to the transport hemoglobin transport oxygen alternation happens in the lungs we talked about that already one hemoglobin picks up one oxygen in addition we have D oxygenation that means to the red that the option gets away from the red blood cells into the tissues and then from there once we've used the option we have co2 as the byproduct and that 90% of that transport is found chemically to soluble by carbon or holy cow something up widget we talked about no we did not talk about that no we talked about by carbon we talked about acids and bases we talked about the buffering system and bicarbonate or the one the stuff you get an alka-seltzer then the stomach acids reduce it Peaks up it Peaks up excessive hydrogen I and so it works the peaks of the the it could transport the carbon dioxide that way in through through the blood into the lungs and then from there get rid of the carbon dioxide in the lungs as a gas so the carbon dioxide most of it is not bound to hemoglobin it's chemically bound to bicarbonate as we get rid of it and breathe it out at once if you want to lose weight the more carbon dioxide you breathe out the more carbons you get rid of fat is a lot of cottage chains so you breathe the way out that's kind of the way to get rid of the brain that's a weight so that's kind of interesting that's good enough for that oxygen and carbon dioxide transport influence each other the oxygenated hemoglobin acts as a stronger base then if oxygenated and therefore tolerates more hydrogen ions which are which are produced when co2 is picked up from the tissues so basically the more the more carbon dioxide is inside the tissues the faster the options going to get rid of the of the hemoglobin into the tissues and helps the tissues be more oxygenated so you have a lot of fine tuning things that will go on and as you get deeper in to understand the system to make sure all the tissues are profused properly and not all left behind now that is good and that brings me to the cool stuff blood proves and that's the end of the story after that so then you're released from sitting here maneet transfuse blood we have more than a hundred different types of cell surface glycoproteins so those are quadruped and and did you think of an engine make you sick that's what you think of an antigen now we have self antigens they don't make us sick our body knows them but then we have all these pathogens these are antigens that come in and the body will respond and react to them now if you have red blood cells and your red blood cells have some surface has them has a surface proteins that cause the reaction they're looked as antigens by somebody else you somebody else will react to that and then the red blood cells will clump together and you participate at you never mind I could kill you and so it was very important that we understand the antigens and then the anti-partisan ones system to make sure we don't have a cross reaction of a blob that's given to a recipient incompatible blood can crack and a blue plate Babbitt RBC's which is called hemolysis is impossible killing a patient to prevent this blood is Sarah logically matched is it the right blood before the transfusion in humans we have two systems we have the system and Emily if the Rx's the RH is deposit negative thing and so we gotta talk about those a little bit more more right now this is why we want to pay attention and I'm just gonna read it before I explain it wrong so the blood groups are four groups that are determined by antigen a and antigen B that are carried on red blood cells so we have therefore Group A to B with baby and group zero or not at all the antigen on the red blood cell is what we're looking at so group a has an antigen an antigen a so that's an antigen let's just say and a on it through P as engine be on it the red blood cells to the a B has both an A and B and all has nothing haha smooth this can be so if you are in your own body a will not react but if you are giving this plug to somebody else know if you give this plug yeah to somebody else who doesn't have das that body will say like what the heck are these antigens we got to do something about and their body is having antibodies against that antigen and they call them empty well here empty a alright so I should take different contexts so that the bond has time on that has the blood that is the B blood will have antibodies in it system the person that are against the other one against the antigen a so if you give this patient this blood is gonna not work out because the anti-polish a will interact with the antigen a on the bottom so antigen is on the cell itself it's what gives to name the plot name that's where the trick comes in and the antibody is using the opposing port in this system so if the B if you only have a blog poop at the end today you've gotta have any TVs in your system so if you can I take this plot and put it in the wrong patient is going to France react bad idea then you're gonna have the one person as antigen a and antigen B on its blog and that person is in luck there is no antibodies but if you have a lot that has no antigen on it you're gonna have both an t body B and antibody a antibody a so this person is a lucky lucky person because you can give them any kind of all you wanna give you keep in with the blood with the a on a who cares you can even want me to pee on it okay you can give them to all the all can go to anybody because the O does not respond to anybody and so the a B is known as the universal recipient and then the all is screwed because the ol can get blood from a or can get proper be or maybe everything reacts the only thing that doesn't react is all to all so in the blood bank you want all the blood to be all if you go to the bank you don't want to be all understand that so the O is the universal donor whereas the Atheist Universal recipient but keep in mind your blood is named after what is on your plotter a V baby or nothing because then we get more complicated we have the Rh factor and the Rh factor is the last one in it's from the system the rhesus monkey to this cause RH because the rhesus monkeys so that was discovered when guinea pigs were injected repealing this blood from rhesus monkeys and they all had bla problems people possess an antigen for that the RH that's known as the Rh positive the people do not have that antigen on the blood cells are known as Rh negative positive or negative all night told the cysts are gone is the RHI bodies are found only after the recipient is sensitized that is after the immune system learns about the RH antigen and slowly makes antibodies against them so a first exposure does not cause a rupture of the foreign or disease but a second exposure will that's like how specific immunity works that's basically you got exposed to the chickenpox or the rhesus the RH now in this respect and then you get sensitized and then you have antibodies against them now in the chickenpox that's great you don't get the chicken pox on you this is not so great because where it gets messy is if you have an orange pot you've got an orange positive baby in a negative mom and when the baby is born you're gonna have spillage and so now the mom will make antibodies against the positive the Rh positive party now this baby's fine the second baby ain't gonna be fine because now the mob has antibodies slowly created against the RH now if she doesn't have what with orange positive meaning it doesn't matter then antibody will not attack that plot but the antibodies will attack the wall of the baby if he has a bad second pregnancy with Rh positive point and that won't work then they may draw again that's all fixed and so so that's right here explained this becomes a problem if an Rh negative mom gives labor to a large positive child during which some of the child's RBC's feel over to the maternal blood sensitizing the maternal blood in the second pregnancy to an Rh positive baby the mothers block now having antibodies against it crossed into the baby's blood that will include making the baby's already season that's a problem we can prevent that medically but we need to know if the baby is positive in the mommy's name and then we can prevent that from happening and I think it's called rocket but I haven't written it down so I'm not so sure if I'm wrong with it isn't that you the footsies I love that I you know what you're touching he sometimes so funny when I'm facing it the bones pregnant there's a pregnant patient and I can I get the Caliphate the video devoid so cute so that is cool it for though that's a nice picture because it helps us understanding and with that look at that it's finished